Iron is absorbed in the duodenum and transported in the plasma bound to transferrin. Excess iron is retained in intestinal mucosal cells as ferritin and later lost during cell turnover to succus entericus. It is the balance between ferritin and transferrin in mucosal cells that largely determines the overall iron status of the individual.
The iron in transferrin is chelated with protoporphyrin to form haem in the bone marrow, liver and spleen; haem is then used to produce haemoglobin, myoglobin and the other haem-based complexes. Excess iron is stored as tissue ferritin or as haemosiderin.
Iron contained red cell haemoglobin is efficiently conserved when these are destroyed: 30mg of iron is released from the reticuloendothelial system daily but only 1-2mg is excreted. The protoporphyrin is converted to bilirubin which is conjugated in the liver and excreted into bile.
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